Gynecomastia

Surgical Treatment of Gynecomastia

Gynecomastia is the palpable breast enlargement in adolescent boys. It is extremely common, and may be found in 30 to 60 percent of boys. Enlargement normally begins about a year after puberty begins. It is frequently on both sides of the chest, but it may start on one side.

Most boys have some pain, tenderness and even nipple discharge. In most cases, gynecomastia gradually resolves on its own over the next year of development.

Gynecomastia SurgeryThere are cases when surgery may be warranted. At WakeMed, our team of pediatric surgeons performs surgery based on recommended standards of care.

In general, the standard treatment for adolescents with idiopathic gynecomastia is to observe the child for a year to see if the condition improves. If the disease persists for greater than one year and if the breast diameter is greater than four centimeters in diameter, the treatment of choice is surgery with the removal of the affected tissue.

The surgery to correct for gynecomastia is a subcutaneous mastectomy. With the child being completely asleep under general anesthesia, the pediatric surgeon makes a small incision at the areola (dark portion of the nipple region). The fibrous or glandular breast tissue is removed, along with tissue that runs from the chest toward the armpit. In some cases, the surgeon may leave a small drainage tube in place while the skin grows back at the incision site. The chest may also be wrapped to help prevent fluid build-up from post-operative bleeding. A small portion of breast tissue will remain under the nipple so that it does not invert.